Gluteal Tendinopathy: A Review of Mechanisms, Assessment and Management

Grimaldi, Alison, Mellor, Rebecca, Hodges, Paul, Bennell, Kim, Wajswelner, Henry and Vicenzino, Bill (2015) Gluteal Tendinopathy: A Review of Mechanisms, Assessment and Management. Sports Medicine, 45 8: 1107-1119. doi:10.1007/s40279-015-0336-5

Author Grimaldi, Alison
Mellor, Rebecca
Hodges, Paul
Bennell, Kim
Wajswelner, Henry
Vicenzino, Bill
Title Gluteal Tendinopathy: A Review of Mechanisms, Assessment and Management
Journal name Sports Medicine   Check publisher's open access policy
ISSN 1179-2035
Publication date 2015-05-13
Year available 2015
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1007/s40279-015-0336-5
Open Access Status Not yet assessed
Volume 45
Issue 8
Start page 1107
End page 1119
Total pages 13
Place of publication Auckland, New Zealand
Publisher Adis International
Collection year 2016
Language eng
Abstract Tendinopathy of the gluteus medius and gluteus minimus tendons is now recognized as a primary local source of lateral hip pain. The condition mostly occurs in mid-life both in athletes and in subjects who do not regularly exercise. Females are afflicted more than males. This condition interferes with sleep (side lying) and common weight-bearing tasks, which makes it a debilitating musculoskeletal condition with a significant impact. Mechanical loading drives the biological processes within a tendon and determines its structural form and load-bearing capacity. The combination of excessive compression and high tensile loads within tendons are thought to be most damaging. The available evidence suggests that joint position (particularly excessive hip adduction), together with muscle and bone elements, are key factors in gluteal tendinopathy. These factors provide a basis for a clinical reasoning process in the assessment and management of a patient presenting with localized lateral hip pain from gluteal tendinopathy. Currently, there is a lack of consensus as to which clinical examination tests provide best diagnostic utility. On the basis of the few diagnostic utility studies and the current understanding of the pathomechanics of gluteal tendinopathy, we propose that a battery of clinical tests utilizing a combination of provocative compressive and tensile loads is currently best practice in its assessment. Management of this condition commonly involves corticosteroid injection, exercise or shock wave therapy, with surgery reserved for recalcitrant cases. There is a dearth of evidence for any treatments, so the approach we recommend involves managing the load on the tendons through exercise and education on the underlying pathomechanics.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2016 Collection
School of Health and Rehabilitation Sciences Publications
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